The specific embodiment
Below further set forth the beneficial effect of medicine of the present invention by clinical experiment.
The clinical trial of rheumatism spray:
The rheumatism spray is that Shenyang Jingcheng Pharmaceutical Co. Ltd. changes the Chinese medicine external spraying agent that dosage form forms with ministry standard " rheumatism tablet ".This medicine is made up of Semen Strychni cream, Radix Clematidis, Herba Siegesbeckiae, Herba Taxilli, Rhizoma Atractylodis Chinese medicine of the five flavours, and its function is an expelling wind and removing dampness, mainly is applicable to the diseases such as lumbago and skelalgia that rheumatic arthritis causes.According to three tame hospitals such as Liaoning Prov. Traditional Chinese Medicine Inst, Hospital Attached to Liaoning Inst. of Traditional Chinese Medicine, Shenyang Inst. of Traditional Chinese Medicine the rheumatism spray has been carried out 100 routine clinical observation on the therapeutic effect and safety examination, now will observe and examine or check the result to be reported as follows;
One, clinical data
Observation group's (rheumatism spray) 100 examples, male's 47 examples wherein, women's 53 examples.Out-patient's 44 examples, inpatient 56 examples.Minimum 19 years old of age, maximum 65 years old ,≤35 years old person's 23 example, 36~45 years old 25 example, 46~60 years old 40 example, 〉=61 years old 12 example.The course of disease is the shortest 5 days, and is the longest 25 years,<half a year person's 17 examples, 〉=half a year 46 example, 〉=3 years 15 examples, 〉=5 years 22 examples.State of an illness the lighter's 22 examples, moderate 47 examples, heavy person's 31 examples.(rheumatism tablet) 60 examples in the matched group, male's 22 examples wherein, women's 38 examples.Out-patient's 27 examples, inpatient 23 examples.Minimum 9 years old of age, maximum 65 years old ,≤35 years old person's 13 example, 36~45 years old 18 example, 46~60 years old 20 example, 〉=61 years old 9 example.The course of disease is the shortest 7 days, and is the longest 20 years,<half a year person's 8 examples, 〉=half a year 26 example, 〉=3 years 10 examples, 〉=5 years 16 examples.State of an illness the lighter's 16 examples, moderate 31 examples, heavy person's 13 examples.Two groups of cases of observation group and matched group are in sex age (segmentation), the course of disease (segmentation), the state of an illness and outpatient service and adopt aspects such as case through X in hospital
2Detect difference that there are no significant, P>0.05.Point out two groups of cases to have harmony and comparability.
Two, case choice criteria
(1) diagnostic criteria
Work out following Chinese and western medicine diagnostic criteria and disease type standard according to " the clinical research guideline of new Chinese medicine treatment arthromyodynia " about diagnostic criteria.
1, tcm diagnosis standard
(1) main clinical manifestation; Every pain or swelling such as joint, muscle, muscles and bones.
(2) characteristics of incidence: how relevant with climate change.
(3) physico-chemical examination: erythrocyte sedimentation rate speeds, and the X ray examination is got rid of the sclerotin infringement.Possess (1), (2) item,
Can make a definite diagnosis in conjunction with (3) item.
2, Chinese medical discrimination standard
Syndrome of cold-dampness blocking collaterals: limbs joint pain is heavy, or swelling, and local fear of cold, color of the leather are not red, and that touches is not hot, pain increase in intensity under coldness, and pain alleviated while getting warmth, enlarged tongue, matter is light dark, the greasy in vain or whiten of tongue, stringy and tense pulse or string are slow.
3, Western medicine diagnose standard
Rheumatic arthritis
(1) clinical manifestation: the streptococcal infection medical history is arranged.Acute stage, can have multiple and the migration joint aches, mostly occurs in big joint, can accompany red and swollen pain or tuberosity or erythema, and chronic phase can only be felt joint aches.
(2) laboratory examination: erythrocyte sedimentation rate speeds, or the C-reactive protein positive.
(2) test case standard
1, includes the case standard in
In all meeting, Western medicine diagnose and Chinese medical discrimination standard person, can include the test case in.
2, get rid of case standard (comprising inadaptation or rejecting standard)
(1) takes Western medicine or other drug person for a long time, more than necessary inactive January, otherwise get rid of.
(2) age is under-18s or over-65s person, and gestation is prepared gestation or women breast-feeding their children;
(3) merge serious primary disease such as cardiovascular, liver, kidney and hemopoietic system, psychotic.
(4) permanent disability or extremity dysfunction person are arranged, skin injury or suffer from dermatosis should not be with this medicine person.
(5) contain Semen Strychni medicine and this medicine allergy sufferers to taking.
Three, clinic observation index
(1) safety indexes
1, general physical examination project
2, blood, urine, just conventional, electrocardiogram, liver function, kidney merit are checked
3, observation is to the stimulation and the allergic phenomena of skin.
(2) health giving quality observation index
1, observes muscle arthralgia, heavy, swelling, part situation of change before and after symptom such as cool sense or fear of cold, pain increase in intensity under coldness and tongue, the arteries and veins treatment is arranged.
2, physics and chemistry such as erythrocyte sedimentation rate detects the situation of change before and after the index treatment.
Four, grouping and observation and administrated method
Adopt the table of random number method to carry out random packet, and observe medication with non-blind method.
Observation group's 100 examples, the external rheumatism spray: administration every day 4 times, spray 6 times (being equivalent to 006 milliliter) at every turn.
Matched group 60 examples, oral rheumatism tablet: each 3, every day 2 times.
15 days is a course of treatment, all observes two courses of treatment.Drug withdrawal was carried out second course of treatment in three days again after first course of treatment.Inactive other curative medicine during the course of treatment.
Five, curative effect determinate standard
1, clinical cure: clinical symptoms all disappears, and it is normal that the tongue arteries and veins recovers, and the integrated value after the treatment is zero, and physics and chemistry detects index and recovers normal.
2, produce effects: clinical symptoms is most of to disappear, and descends 〉=2/3 than integrated value before the treatment after the treatment, and physics and chemistry detection index is obviously improved.
3, effective: clinical symptom relief, integrated value descended<2/3, 〉=1/3 before treated the treatment back, and physics and chemistry detects index improvement.
4, invalid: clinical symptoms is improved not obvious or is increased the weight of, and integrated value descended<1/3 before treated the treatment back, and physics and chemistry detects index does not have improvement.
Six, observed result
(1) observation group and matched group clinical efficacy are relatively
As seen from Table 1, above percentage rate of observation group's produce effects and total effective rate are respectively 47% and 91%, and above percentage rate of matched group produce effects and total effective rate are respectively 26.3% and 83.3%.Two groups total effective rate is analyzed through Ridit, u=1.38, and there was no significant difference, P>0.05 points out two groups curative effect close.
Table 1. liang group clinical efficacy relatively
| Clinical cure produce effects enabledisable produce effects |
Group | Example numerical example (%) example (%) example (%) example (%) above rate (%) total effective rate (%) |
Observation group's matched group | 100??13???13.0??34??34.0?44??44.0??9???9.0?????47.0????91.0 60???5????8.3???18??30.0?27??45.0??10??16.7????26.3????83.3 |
(2) observation group and matched group pain relieving onset time comparison
As seen from Table 2, average pain relieving onset time of observation group is 4.86 ± 7.91 hours, and average pain relieving onset time of matched group is 55.01 ± 48.01 hours.Through the T check, there is significant differences P<0.001.The time that the pain relieving onset of prompting observation group occurs is obviously early than matched group.
Table 2. liang group pain relieving onset time comparison (X ± SD)
Group matched group matched group | Example several 100 60 | Pain relieving onset time (hour) 4.86 ± 7.91 0 55.01 ± 48.01 |
Annotate:
* *P<0.01
(3) the clinical cardinal symptom curative effect of observation group and matched group relatively
Seeing that from table 3 by muscle arthralgia in observation group and the matched group group, limbs are heavy, feels cold in the part, swelling, and local fear of cold, integral mean relatively all has significant differences, P<0.001 before and after 6 cardinal symptom treatments such as pain increase in intensity under coldness.Point out two groups of medicines that above-mentioned 6 symptoms are all had tangible curative effect.By 6 symptom difference meansigma methodss between group are compared, 2 symptoms of muscle arthralgia and swelling have significant differences, P<0.01 as a result.Prompting observation group obviously is better than matched group to the curative effect of above-mentioned 2 symptoms.
Table 3. liang group cardinal symptom curative effect comparison (X ± SD)
Cardinal symptom | Observation group's matched group |
Control before example is controlled and control the back difference before back difference example is controlled |
Muscle joint 100 4.72 ± 1.08 1.76 ± 2.56
***??3.16±1.18
△△?60??4.50±1.36??1.80±1.20
***2.60 ± 1.29 limbs heavy 91 3.98 ± 1.51 1.45 ± 1.30
***??2.49±1.42?????52??3.92±1.48??1.46±1.49
***2.42 ± 1.45 local cool 96 2.07 ± 0.62 0.74 ± 0.77
***??1.32±0.77?????55??1.98±0.68??0.80±0.73
***1.20 ± 0.68 swelling 61 1.74 ± 0.75 0.41 ± 0.72
***??1.31±0.76
△△?44??1.52±0.63??0.45±0.63
***0.91 ± 0.64 local fear of cold 97 2.11 ± 0.72 0.80 ± 0.72
***??1.31±0.74?????59??2.02±0.75??0.91±0.77
***1.12 ± 0.77 pain increase in intensity under coldness 99 2.22 ± 0.69 0.88 ± 0.72
***??1.54±2.03?????59??2.12±0.79??0.98±0.75
***??1.13±0.71
|
Annotate: compare in the group
* *Compare between group P<0.001
△ △<001
(4) observation group and matched group physics and chemistry compare before and after detecting the treatment of index measured value
From table 4-1 as seen, the erythrocyte sedimentation rate measured value relatively through the t check, all has significant differences, P<0.001 before and after observation group and the matched group group internal therapy.Point out two groups of erythrocyte sedimentation rate measured values that obvious reduction performance is all arranged, compare there was no significant difference, P>0.05 by difference between two groups the erythrocyte sedimentation rate value.Point out the effect of two groups of reduction erythrocyte sedimentation rate measured values close.From table 4-2 as seen, the c reactive protein negative rate compared with treatment back negative rate before observation group treated, through X
2Check, there is highly significant difference P<0.01, and negative rate compared with treatment back negative rate before the matched group c reactive protein was treated, through X
2Check, also there is significant difference P<0.05, and treatment back negative rate compares P>0.05 there was no significant difference between two groups.Prompting observation group is to the c reactive protein effect of turning out cloudy, and matched group has the effect of necessarily turning out cloudy, but two groups close to the c reactive protein effect of turning out cloudy.
Compare before and after the unusual measured value treatment of two groups of erythrocyte sedimentation rate of table 4-1 (X ± SD)
Group observation group matched group | Example several 100 60 | (mm/n) 39.99 before the treatment ± 22.26 40.13 ± 25.76 | Treatment back (mm/n) 17.14 ± 9.19
***19.16±9.99
*** | Difference (mm/n) 22.9. ± 22.41 20.67 ± 2.066 |
Compare before and after the treatment of table 4-2 two C-reactive protein measured values
| Negative rate before the treatment | Treatment back negative rate |
Group observation group matched group | Example several 55 30 | Positive negative (%) 37 18 32.7 20 10 33.3 | Positive negative (%) 19 36
**??65.5 12????18
*???60.0
|
Annotate: compare in 4-1, the 4-2 group
* *P<0.001
*P<0.01
*P<0.05
(5) relation of the state of an illness and curative effect
As seen from Table 5, observation group light, in, heavy different state of an illness total effective rates are respectively 100%, 89.4% and 87.1%.Analyze through Ridit, Ridit value credibility interval is respectively 0.5123~0.7535,0.4175~0.5825,0.3596~0.5628, and intersection is all arranged.Prompting observation group medicine to light, in, heavy different state of an illness curative effects are close.
The relation of table 5. state of an illness and curative effect
| Clinical cure | Produce effects | Effectively | Invalid | |
47 is heavy by 31 in the state of an illness example number light 22 | Example (%) 4 18.2 7 14.9 2 6.4 | Example (%) 11 50.0 13 27.7 10 32.3 | Example (%) 7 31.8 22 46.8 15 48.4 | Example (%) 005 10.6 4 12.9 | Total effective rate (%) 100 89.4 87.1 |
(6) relation of the course of disease and curative effect
As seen from Table 6, the course of disease<half a year, 〉=half a year, 〉=3 years, 〉=total effective rate in 5 years is respectively 94.1%, 97.8%, 73.3% and 86.4%.Its total effective rate is analyzed through Ridit, and the credibility interval of Ridit value is respectively 0.5399~0.8143,0.4166~0.5834,0.1433~0.4345,0.2124~0.4536.Wherein the course of disease<half a year and 〉=3 years, 〉=the Ridit value credibility interval in 5 years do not have and intersects, and significant difference arranged, P<0.05.And other all have intersection, there was no significant difference, P>0.05.Prompting observation group medicine to the curative effect of the course of disease<half a year be better than the course of disease 〉=3 year, 〉=curative effect in 5 years.
The relation of table 6. course of disease and the course of treatment
| | Clinical cure | Produce effects | Effectively | Invalid |
The course of disease | The example number | Example (%) | Example (%) | Example (%) | Example (%) total effective rate (%) |
<half a year 〉=half a year 〉=3 year 〉=5 years | 17 46 15 22 | ?6????35.3 ?6????13.0 ?1????6.67 ?0????0 | ?8????47.1 ?18???39.1 ?2????13.3 ?6????27.3 | ??2?????11.7 ??21????45.7 ??8?????53.3 ??13????59.1 | ?1???5.9??????94.1 ?1???2.2??????97.8 ?4???26.7?????73.3
*?3???136??????86.4
* |
Annotate:
*〉=3 years, 〉=5 years with the<half a year of P<0.05 relatively
(7) relation of the course of treatment and curative effect
As seen from Table 7, the 1st course of treatment and the 2nd the course of treatment total effective rate, analyze through Ridit, u=5.97, there is significant differences p<0.01.Point out the curative effect of the 2nd course of treatment to be better than the curative effect of the 1st course of treatment.
The relation of table 7. course of treatment and curative effect
| | Clinical cure | Produce effects | Effectively | Invalid | |
The 2nd course of treatment of the 1st course of treatment of the course of treatment | Example several 100 100 | Example (%) 3 3.0 13 13.0 | Example (%) 12 12.0 34 34.0 | Example (%) 40 40.0 44 44.0 | Example (%) 45 45.0 9 9.0 | Total effective rate (%) 55.0 91.0
* |
Annotate:
*P<0.05
(8) relation of age and curative effect
As seen from Table 9, the total effective rate of 4 all ages and classes sections is analyzed through Ridit, and the credibility interval of Ridit value is respectively 0.5663~0.8021,0.4473~0.6737,0.4105~0.5895,0.2211~0.5477.Wherein≤the Ridit value confidence region of 35 years old age bracket do not have with 〉=61 years old age bracket credibility interval and intersects, and significant difference arranged, P<0.05.All there is intersection other age bracket credibility intervals, there was no significant difference, P>0.05.Prompting observation group medicine is right≤and the curative effect of 35 years old age bracket is better than 〉=curative effect of 61 years old age bracket.
The relation of table 9. age and curative effect
| Clinical cure | Produce effects | Effectively | Invalid | |
The age≤35 36~45 46~60 | Example several 23 25 40 | Example (%) 6 26.1 3 12.0 4 10.0 | Example (%) 10 43.5 9 36.0 12 30.0 | Example (%) 7 30.4 12 48.0 19 47.5 | Example (%) 001 4.0 5 12.5 | Total effective rate (%) 100
*??96.0 ??87.5
|
Annotate:
*≤ 35 years old and 〉=61 years old comparison P<0.05
Seven, toxic and side effects and untoward reaction
Observation group's medicine wherein has arrhythmia and accidental room early before the 2 example treatments between the operating period of 2 courses of treatment, the state of an illness is not seen and increased the weight of after the medication, checks after the course of treatment that electrocardiogram is reversed to normal ECG.The slight flushing of skin after the 1 routine medication, influence does not continue medication.Menses after other case medications, urine, just routine and liver, renal function, the Electrocardioscopy no abnormality seen changes.It is safe basically that prompting is used this medicine during the course of treatment.
Eight, discussion and conclusion
Discuss:
1. by the new drug rheumatism spray of Shenyang Jingcheng Pharmaceutical Co. Ltd. research, through the Liaoning Prov. Traditional Chinese Medicine Inst, three tame hospitals such as Hospital Attached to Liaoning Inst. of Traditional Chinese Medicine, Shenyang Inst. of Traditional Chinese Medicine belong to syndrome of cold-dampness blocking collaterals patient clinical observation to 100 routine rheumatic arthritis, have obtained clinical efficacy preferably.Above percentage rate of produce effects and total effective rate are respectively 83.3%, 91%.
2. average pain relieving onset time of rheumatism spray is 4.36 ± 7.91 hours, obviously early than average pain relieving onset time of rheumatism tablet.
3. the rheumatism spray is heavy to muscle arthralgia in the rheumatic arthritis syndrome of cold-dampness blocking collaterals, limbs.Local 6 cardinal symptoms such as cold, swelling, local fear of cold, pain increase in intensity under coldness of sending out all have tangible curative effect, and wherein the curative effect to muscle arthralgia and swelling also is better than contrasting the medicine rheumatism tablet.
4. the rheumatism spray has the performance of obvious reduction erythrocyte sedimentation rate measured value and the effect of turning out cloudy of C-reactive protein.
The rheumatism spray to light, in, heavy different state of an illness patients' curative effect is consistent.The rheumatism spray is less than normal to the age, and the short partially patient's of the course of disease curative effect is more obvious.Spray with this medicine to be advisable 2 courses of treatment.
6. using this medicine during the course of treatment is safe on the whole, has no side effect basically.
Conclusion:
From clinical observation and safety examination result, the rheumatism spray is that the onset of a kind of treatment rheumatic arthritis syndrome of cold-dampness blocking collaterals is very fast, and curative effect is better, and is easy to use, and essentially no toxic and side effects is safer new Chinese medicine preparation.
Embodiment one
Medicine of the present invention is made up of Semen Strychni cream 54g, Radix Clematidis 900g, Herba Siegesbeckiae 900g, Herba Taxilli 720g, Rhizoma Atractylodis g, sodium benzoate 3g;
Its technology that is prepared into spray is comprised the steps:
A, got the Rhizoma Atractylodis reflux, extract, 3.5 hours, aqueous solution and medicinal residues after the Rhzoma Atractylodis Lanceae volatile oil of extraction, the distillation are standby;
B, with above-mentioned medicinal residues with after Radix Clematidis, Herba Siegesbeckiae, Herba Taxilli mix, the extracting in water secondary adds 8 times in water for the first time, adds 8 times in water for the second time, each 1 hour, collecting decoction merged with above-mentioned aqueous solution, filter, filtrate;
C, in above-mentioned filtrate, add Semen Strychni cream after, mixing left standstill 12 hours, got supernatant, being evaporated to relative density is 1.05 (35 ℃), leaves standstill 10 hours, centrifugal 1500-3000 rev/min, centrifugation time is 3-4 minute, supernatant;
D, add Rhzoma Atractylodis Lanceae volatile oil and sodium benzoate in above-mentioned supernatant, mixing filters, fill, promptly.
The method for making of above-mentioned Semen Strychni cream is: get Semen Strychni, make solvent with 70% ethanol, flood after 50 hours, with the percolation slowly of the speed about per minute 1ml, treat that strychnine filters out fully, collect the liquid of filtering, evaporation, after adding the paraffin thawing of 0.2 times of Semen Strychni weight while hot, powerful jolting is placed, treat cold, the agglomerative paraffin layer of break-through takes out solution, is evaporated to the thick paste shape.
The content of strychnine is 3% in the described Semen Strychni cream.
Embodiment two
Medicine of the present invention is made up of Semen Strychni cream 54g, Radix Clematidis 900g, Herba Siegesbeckiae 900g, Herba Taxilli 720g, Rhizoma Atractylodis g, sodium benzoate 3g;
Its technology that is prepared into spray is comprised the steps:
A, got the Rhizoma Atractylodis reflux, extract, 4 hours, aqueous solution and medicinal residues after the Rhzoma Atractylodis Lanceae volatile oil of extraction, the distillation are standby;
B, with above-mentioned medicinal residues with after Radix Clematidis, Herba Siegesbeckiae, Herba Taxilli mix, the extracting in water secondary adds 9 times in water for the first time, adds 6 times in water for the second time, each 1.5 hours, collecting decoction merged with above-mentioned aqueous solution, filter, filtrate;
C, in above-mentioned filtrate, add Semen Strychni cream after, mixing left standstill 12 hours, got supernatant, being evaporated to relative density is 1.08 (40 ℃), leaves standstill 12 hours, centrifugal 2000 rev/mins, centrifugation time is 5-20 minute, supernatant;
D, add Rhzoma Atractylodis Lanceae volatile oil and sodium benzoate in above-mentioned supernatant, mixing filters, and filtrate adds water to 1000ml, fill, promptly.
Other is with embodiment one.
Embodiment three
Medicine of the present invention is made up of Semen Strychni cream 54g, Radix Clematidis 900g, Herba Siegesbeckiae 900g, Herba Taxilli 720g, Rhizoma Atractylodis g, sodium benzoate 3g;
Its technology that is prepared into spray is comprised the steps:
A, got the Rhizoma Atractylodis reflux, extract, 5 hours, aqueous solution and medicinal residues after the Rhzoma Atractylodis Lanceae volatile oil of extraction, the distillation are standby;
B, with above-mentioned medicinal residues with after Radix Clematidis, Herba Siegesbeckiae, Herba Taxilli mix, the extracting in water secondary adds 10 times in water for the first time, adds 8 times in water for the second time, each 3 hours, collecting decoction merged with above-mentioned aqueous solution, filter, filtrate;
C, in above-mentioned filtrate, add Semen Strychni cream after, mixing left standstill 14 hours, got supernatant, being evaporated to relative density is 1.10 (50 ℃), leaves standstill 14 hours, centrifugal, supernatant;
D, add Rhzoma Atractylodis Lanceae volatile oil and sodium benzoate in above-mentioned supernatant, mixing filters, fill, that is and, other is with embodiment one.